tbuckley/cabot-search huggingface dataset:
Temsirolimus (T) in patients (pts) with solid tumors with <i>PIK3CA </i>mutation (mut): Results from the Targeted Agent and Profiling Utilization Registry (TAPUR) study.
Authors: Carmen Julia Calfa, Michael Rothe, Gordan Srkalovic, Herbert Leon Duvivier, Deepti Behl, J Michael Straughn, Kathleen J Yost, Inderjit Mehmi, Evan P. Pisick, Bhavina B Sharma, Ramya Thota, Dan Steven Veljovich, Olatunji B. Alese, Timothy Lewis Cannon, Anu G. Gaba, Walter John Urba, Margaret von Mehren, Gina N. Grantham, Susan Halabi, Richard L. Schilsky
Journal: Journal of Clinical Oncology (2023)

3117 Background: TAPUR is a phase II basket study evaluating antitumor activity of commercially available targeted agents in pts with advanced cancers with genomic alterations. Results in cohorts of pts with breast cancer (BC) and other solid tumors with PIK3CA mut treated with T are reported. Methods: Eligible pts had BC or other solid tumors, measurable disease, ECOG performance status (PS) 0-2, adequate organ function, and no standard treatment (tx) options. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. After antihistamine pre-tx, 25 mg of T was infused over 30-60 minutes once weekly until disease progression. Primary endpoint was disease control (DC), defined as complete or partial (PR) response, or stable disease of at least 16+ weeks (wks) duration (SD16+) per RECIST v1.1. For the BC cohort, Simon’s optimal 2-stage design with null DC rate of 15% vs. 35% (power=0.85, α=0.10) was used with stage 1 (n=10) stopping for futility if &lt; 2/10 pts had DC. Low accruing histology-specific cohorts with PIK3CA and T tx were collapsed into 1 histology-pooled (HP) cohort. For the HP cohort, the hypothesized null DC rate of 15% was evaluated by a 1-sided exact binomial test with α=0.10. Secondary endpoints were progression-free survival (PFS), overall survival (OS), and safety. Results: 12 pts with PIK3CA mut with BC and 29 pts with PIK3CA mut in other solid tumors (across 9 tumor types) were enrolled. 2 pts (1 in each cohort) were found to be ineligible after enrolling and were not included in efficacy analyses. Demographics and outcomes for each cohort are shown. At the end of stage 1 in the BC cohort, 1 PR was observed for DC and OR rates of 9%; the cohort was closed for futility (p=0.83). For the HP cohort, 3 PR and 5 SD16+ were observed for DC rate of 29% (p=0.049) and OR rate of 11%; the null hypothesis was rejected. Cancer types in pts with OR or SD16+ included cervical, ovarian and head/neck; most common muts were H1047R/L (3), E545K (2) and E542K (2). 1 pt with ovarian and H1047R has ongoing PR at 86 wks. 11/41 pts had ≥1 tx-related grade 3-4 adverse or serious adverse event, including anemia, headache, hyperglycemia, hypertension, hypertriglyceridemia, mucositis oral, lymphocyte, neutrophil or platelet count decrease, pneumonitis, and sepsis. Conclusions: Although T does not appear to have antitumor activity in pts with BC with PIK3CA mut, it does show antitumor activity in pts with other solid tumors with PIK3CA mut and warrants further study. Clinical trial information: NCT02693535 . [Table: see text]
A phase II study of hyper-CVAD with blinatumomab (blina) and inotuzumab ozogamicin (INO) for newly diagnosed Philadelphia chromosome (Ph)–negative B-cell acute lymphoblastic leukemia (ALL).
Authors: Nicholas James Short, Elias Jabbour, Nitin Jain, Fadi Haddad, Walid Macaron, Musa Yilmaz, Alessandra Ferrajoli, Tapan M. Kadia, Yesid Alvarado Valero, Abhishek Maiti, Lewis Fady Nasr, Marianne Zoghbi, Cedric Christophe Nasnas, Rebecca Garris, Min Zhao, Marina Konopleva, Farhad Ravandi, Hagop M. Kantarjian
Journal: Journal of Clinical Oncology (2023)

e19017 Background: Consolidation with blina, regardless of measurable residual disease (MRD) status, improves overall survival (OS) in adults with newly diagnosed B-cell ALL. The addition of INO may deepen responses and further improve outcomes. Methods: Patients (pts) 14-59 years of age with newly diagnosed Ph-negative pre-B-cell ALL, including pts who had received no more than 1 prior cycle of chemotherapy, were eligible. Pts received hyper-CVAD alternating with high-dose MTX/Ara-C for up to 4 cycles, followed by 4 cycles of Blina at standard doses. Pts with CD20+ disease received 8 doses of an anti-CD20 antibody. Eight doses of prophylactic IT chemotherapy were given. Maintenance was with alternating blocks of POMP (maintenance cycles 1-3, 5-7, 9-11, and 13-15) and Blina (maintenance cycles 4, 8, and 12). Beginning with pt #39, INO at a dose of 0.3 mg/m2 on day 1 and 8 was added to the 2 cycles of MTX/Ara-C and to 2 cycles of Blina consolidation (4 total cycles with INO). Results: To date, 69 pts have been treated (38 without INO and 31 with INO). Baseline characteristics are summarized in the table. Among 53 pts with active disease at study entry, 100% achieved CR. MRD negativity by flow was achieved in 56/59 evaluable pts (95%). Of the 3 pts who did not achieve MRD negativity, 2 were later found to have a NUP214: ABL1 fusion, and 1 had KMT2A rearrangement. The median follow-up of the entire cohort is 26 months. Overall, 8 pts (12%) relapsed while on study, 22 (32%) underwent stem cell transplant (SCT) in first remission (2 of whom relapsed post-SCT), 2 (3%) died in CR, and 37 (54%) remain in continuous remission without SCT. For the entire cohort, the estimated 3-year OS was 87% and the 3-year continuous remission duration was 83%. With a median follow-up in the INO cohort of 15 months, 3 pts (10%) have relapsed, all with CNS-only relapses, and none has died. The 15-month OS in the cohorts with and without INO were 100% and 87%, respectively (P=0.06). One pt discontinued Blina due to recurrent grade 2 neurotoxicity. No pts have discontinued INO due to toxicity and no cases of SOS/VOD have been observed. Conclusions: In pts with newly diagnosed Ph-negative B-cell ALL receiving hyper-CVAD with sequential Blina, OS may be improved with the addition of INO. Clinical trial information: NCT02877303 . [Table: see text]
Nivolumab (NIVO) plus chemotherapy (chemo) vs chemo as first-line (1L) treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC): 3-year follow-up from CheckMate 649.
Authors: Yelena Y. Janjigian, Kohei Shitara, Markus H. Moehler, Marcelo Garrido, Carlos Gallardo, Lin Shen, Kensei Yamaguchi, Lucjan Wyrwicz, Tomasz Skoczylas, Arinilda Silva Campos Bragagnoli, Tianshu Liu, Mustapha Tehfe, Elena Elimova, Ricardo Elias Bruges Maya, James M. Cleary, Michalis Karamouzis, Samira Soleymani, Ming Lei, Carlos Amaya-Chanaga, Jaffer A. Ajani
Journal: Journal of Clinical Oncology (2023)

4025 Background: NIVO + chemo demonstrated superior overall survival (OS) and clinically meaningful progression-free survival (PFS) benefit vs chemo and acceptable safety in previously untreated patients (pts) with advanced GC/GEJC/EAC, leading to approvals in multiple countries including the US. NIVO + chemo continued to demonstrate clinically meaningful improvement in efficacy after 2 years of follow-up. We present efficacy and safety analyses from NIVO + chemo vs chemo from the 3-year follow-up of CheckMate 649. Methods: Adults with previously untreated, unresectable advanced, or metastatic GC/GEJC/EAC were enrolled, regardless of programmed death ligand 1 (PD-L1) expression, excluding pts with known HER2-positive status. Pts were randomized to NIVO (360 mg Q3W or 240 mg Q2W) + chemo (XELOX Q3W or FOLFOX Q2W), NIVO + ipilimumab, or chemo. Primary endpoints for NIVO + chemo vs chemo were OS and PFS by blinded independent central review (BICR) in pts with PD-L1 combined positive score (CPS) ≥ 5. Results: 1581 pts were concurrently randomized to NIVO + chemo or chemo. With 36-month (mo) minimum follow-up, NIVO + chemo continued to demonstrate OS and PFS benefit vs chemo in pts with PD-L1 CPS ≥ 5 and all randomized pts. The objective response rate (ORR) per BICR in pts with PD-L1 CPS ≥ 5 who had measurable lesions at baseline was 60% (95% CI 55–65) with NIVO + chemo vs 45% (95% CI 40–50) with chemo; in all randomized pts, ORR per BICR was 58% (95% CI 54–62) with NIVO + chemo vs 46% (95% CI 42–50) with chemo. Responses were more durable with NIVO + chemo vs chemo in pts with PD-L1 CPS ≥ 5 (median [m] duration of response [mDOR] 9.6 mo [95% CI 8.2–12.4] vs 7.0 mo [95% CI 5.6–7.9], respectively) and in all randomized pts (mDOR 8.5 mo [95% CI 7.7–9.9] vs 6.9 mo [95% CI 5.8–7.2], respectively). OS benefit with NIVO + chemo was observed across most prespecified subgroups. No new safety signals were identified. A summary of treatment-related adverse events (TRAEs) is shown in the Table. Additional analyses will be presented. Conclusions: After 3 years of follow-up, NIVO + chemo continued to demonstrate clinically meaningful long-term survival benefit with acceptable safety, further supporting its use as a standard 1L treatment in previously untreated pts with advanced GC/GEJC/EAC. Clinical trial information: NCT02872116 . [Table: see text]
Translationally controlled tumor protein as a prognostic marker in metastatic colon cancer.
Authors: Dragomir Svetozarov Stoyanov, Mariya Penkova, Nikolay Conev, Ivan Donev
Journal: Journal of Clinical Oncology (2023)

e15513 Background: The translationally controlled tumor protein (TCTP) is a highly conserved protein present in virtually all eukaryotic organisms. TCTP is involved in a variety of normal cell functions and disease processes. Preclinical studies reveal that TCTP has anti-apoptotic properties, promotes cell growth and division, and is involved in cancer progression by promoting invasion and metastasis. Our study explores the potential value of TCTP as a prognostic marker in metastatic colon cancer. Methods: A retrospective analysis of 54 patients with primary metastatic colon cancer was performed. Using immunohistochemistry, TCTP levels in the primary tumor were assessed semiquantitatively via the calculation of cytoplasmic and nuclear H-score. Results: Cytoplasmic TCTP levels in the primary tumor had no statistically significant association with progression-free survival in first-line therapy (PFS1) and overall survival (OS) in our patient population. Patients whose primary tumors had a negative nuclear TCTP expression had significantly better clinical outcomes. The PFS1 for the negative nuclear TCTP expression group was 7.4 months (95% CI, 5.3-9.6) vs 4.5 months (95% CI, 3.4-5.6) in the group with positive nuclear expression (p = 0.023). Patients with a negative nuclear expression of TCTP had a significantly higher median OS (17.1 months; 95% CI, 13.5–20.6) compared to those with positive TCTP nuclear expression (median 11.5 months; 95% CI, 8.5-14.5) (p = 0.031). In Cox regression analyses, a positive nuclear TCTP H-score conferred a higher risk for worse PFS1 (HR 1.960; 95% CI, 1.086-3.537; p = 0.025) and OS (HR 1.882; 95% CI, 1.050-3.371; p = 0.034). The 1-year OS rate in the group with negative nuclear TCTP expression was 80.0% compared to 47.4% in patients with positive nuclear TCTP expression (p = 0.03). Conclusions: The present study suggests that semiquantitative H-score measurement of TCTP levels in the nuclei of tumor cells from the primary tumor is a potential prognostic marker for clinical outcomes in patients with metastatic colon cancer.
Novel blood-based assay for detection of early stage multi-cancer.
Authors: Jeffrey P. Gregg, Franziska Michor, Caitlin Gilley, Miguel Williams, Esther Brown, Kyle Gowen, Dorna KashefHaghighi, James Sun, Amirali Kia, Jocelyn Charlton
Journal: Journal of Clinical Oncology (2023)

e15035 Background: Early cancer detection has the potential to significantly improve patient outcomes and reach the Cancer Moonshot goals of reducing the death rate from cancer by at least 50 percent over the next 25 years. Harbinger Health is pioneering early cancer detection with a blood-based test that combines recent genomic and epigenomic discoveries of early cancer and biology-informed artificial intelligence. Unlike prior approaches that are purely statistical to identify informative biomarkers, Harbinger’s approach is informed by insights into specific biological events early during tumorigenesis and is therefore optimized for detecting cancer in patients with very low levels of circulating tumor DNA. Methods: Here, we present data generated using the Harbinger Health assay from 1,046 subjects, 621 with newly diagnosed, treatment-naive cancer (15 different cancer types) and 425 individuals with no history, diagnosis, or cancer symptoms. Using this sample cohort, we developed and applied a rigorous framework for training, calibration and predicting likelihood of cancer using a multi-layered logistic regression-based machine learning algorithm, generating final outputs of binary classification (cancer yes/no). Our framework involved multiple iterations of 10-fold cross-validation of the full dataset, and we report solely on samples that appear in the held-out test set in each iteration. Additionally, we developed a similar framework to predict tissue of origin (TOO) for cancer samples. Results: The overall sensitivity of cancer detection was 82% (95% confidence interval (CI): 72.7-91.0%) at 95% specificity. Notably, the sensitivity was 74% (95% CI: 54.8-92.7%) for stage 1 and 84% (95% CI: 65.3-100%) for stage 2. Furthermore, we were able to correctly predict cancer in 95% of patient samples with at least 0.037% tumor fraction. The overall sensitivity for high incident cancers were: breast (73%), prostate (82%), lung (85%), and colorectal (96%) at 95% specificity and the overall accuracy of TOO prediction was 86% when the tumor fraction was greater than 0.1% in the top 3 most prevalent cancer types (breast, colorectal and lung). Importantly, we noted that technical variability was introduced when performing assay optimization strategies, yet we observed comparable performance when assessing subsets of stably processed samples, indicating that our performance is robust. Conclusions: Overall, these results demonstrate that the Harbinger Health platform, with its biology-informed approach, has the potential for highly sensitive multi-cancer diagnostic accuracy and specifically those with early-stage cancer. The platform is now being validated in a 10,000-subject prospective clinical trial (CORE-HH/NCT05435066).
Tislelizumab (TIS) versus sorafenib (SOR) in first-line (1L) treatment of unresectable hepatocellular carcinoma (HCC): The RATIONALE-301 European/North American (EU/NA) subgroup.
Authors: Arndt Vogel, Tim Meyer, Eric Assenat, Mariona Calvo Campos, Songzi Li, Yaxi Chen, Frederic Boisserie, Ramil Abdrashitov, Donatella Marino, Richard S. Finn
Journal: Journal of Clinical Oncology (2023)

4082 Background: HCC is one of the most commonly diagnosed cancers globally. Most cases occur in Asia, although a number of patients (pts) are affected in Europe and North America. In the phase 3, open-label RATIONALE-301 trial (NCT03412773), TIS, a PD-1 inhibitor, showed non-inferior overall survival (OS) versus SOR (hazard ratio 0.85, 95% CI: 0.71, 1.02), and a favorable safety profile, in 1L treatment of pts with unresectable HCC. Here, efficacy and safety of TIS versus SOR in the RATIONALE-301 EU/NA subgroup were compared with the overall population (OP). Methods: Systemic therapy-naïve adults with histologically confirmed HCC were randomized (1:1) to receive TIS (200 mg IV Q3W) or SOR (400 mg orally BID) until disease progression, intolerable toxicity, or withdrawal. The primary endpoint was OS; secondary endpoints included objective response rate (ORR), progression-free survival (PFS), and duration of response (DoR) by blinded independent review committee per RECIST v1.1, and safety. Results: In the EU/NA subgroup (172/674 pts randomized), at data cutoff (July 11, 2022), median (m) OS follow-up was 37.9 months (mo) (TIS) vs 38.5 mo (SOR). At baseline, fewer pts in the EU/NA subgroup had Barcelona Clinic Liver Cancer (BCLC) Stage C disease (70% vs 78%) and extrahepatic spread (51% vs 62%), and more had a non-viral etiology (60% vs 24%) or underlying HCV infection (28% vs 13%) than in the OP, respectively. Distribution of other baseline characteristics was generally similar between the EU/NA subgroup and the OP. Efficacy data in the EU/NA subgroup were consistent with the OP. Numerically longer mOS and mDoR, higher ORR, and similar mPFS were observed with TIS versus SOR in the EU/NA subgroup. In the EU/NA safety population, incidence of ≥grade 3 treatment-emergent adverse events (TEAEs; 46% vs 66%), ≥grade 3 treatment-related TEAEs (TRAEs; 17% vs 50%), and TRAEs leading to discontinuation (9% vs 15%) was lower with TIS versus SOR, respectively, similar to the OP. Conclusions: In the RATIONALE-301 EU/NA subgroup, mOS of TIS was non-inferior versus SOR, consistent with the findings from the OP. Numerically longer mOS and mDoR, and a higher ORR was seen with TIS versus SOR in the EU/NA subgroup, which had a higher rate of pts with non-viral etiology and a slightly lower number of pts with advanced-stage disease (BCLC Stage C) compared with the OP. Clinical trial information: NCT03412773 . [Table: see text]
piRNA-14633 underexpression as an independent prognostic marker in non-small cell lung cancer.
Authors: Wei Peng, Jingfeng Mei, Jifeng Feng
Journal: Journal of Clinical Oncology (2023)

e21223 Background: To determine the expression and function of piRNA-14633 in non-small cell lung cancer (NSCLC) samples were taken from cancer lesions (n = 30) and adjacent normal tissue (n = 30) in NSCLC patients. Methods: piRNA-14633 expression was determined by real-time reverse transcriptase polymerase chain reaction (RT-PCR). The effect of piRNA-14633 overexpression was examined in vitro utilizing a human NSCLC cell line H1650 stably transfected with a recombinant lentivirus and compared to empty vector-transfected controls. piRNA-14633 overexpression was verified by RT-PCR. The expression of proteins involved in cell cycle regulation (CDK4) and apoptosis (Bcl-6) and cell migration (MMP-9) in cells was analyzed by Western blot. The effect of piRNA-14633 overexpression on cell viability and proliferation was assessed by an MTT assay cells. Flow cytometric analyses were used to evaluate the effect of piRNA-14633 expression on cell cycle distribution and apoptosis. The migration and invasion potential of piRNA-14633 cells was examined by plating cells in Matrigel-coated chambers. Results: The level of piRNA-14633 expression was found to be significantly lower in NSCLC tissue than normal tissues (P &lt; 0.05). Decreased expression of piRNA-14633 was significantly correlated with lymph node metastasis, clinical stage, and histological grade of patients with NSCLC (P &lt; 0.05). Meanwhile, loss of piRNA-14633 expression correlated significantly with poor overall survival time by Kaplan-Meier analysis (P &lt; 0.05). The result of biological function shown that H1650 cell-transfected piRNA-14633 had a lower survival fraction, higher percentage of the G0/G1 phases, higher cell apoptosis, significant decrease in migration and invasion, and lower CDK4, Bcl-6, and MMP-9 expression compared with H1650 cell without piRNA-14633 (P &lt; 0.05). Conclusions: Reduced piRNA-14633 expression is associated with increased disease severity, suggesting it is a negative regulator of NSCLC and can serve as a prognostic indicator.
A phase 1 study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics and immunogenicity of LB4330, a peptide fused to CLDN18.2 antibody targeting the tumor antigen associated CD8+t CELLS in patients with advanced solid tumors.
Authors: Jiajian Liu
Journal: Journal of Clinical Oncology (2023)

TPS4196 Background: PD-1/PD-L1-targeted immunotherapies have become critical roles in the treatment for many tumors. However, there is limited progress in pancreatic ductal adenocarcinoma (PDAC). PDAC is low immunogenicity. PDAC microenvironment is immunosuppressive. More than 70% PDACs have few or no CD8+ T cells around the tumor cell or in the tumor microenvironment (TME). Therefore, immunotherapy like PD-1/PD-L1 antibody alone is rarely effective for PDACs. Some cytokine or analogs may activate CD8+ T cells. An analog specifically activating tumor antigen associated (TAA) CD8+ T cells was designed and fused to anti-CLDN18.2 antibody. This specific bi-functional molecule LB4330 has high affinity to human anti-CLDN18.2 (14pM) and CD8+T cells. LB4330, as a novel, first-in-class molecule, may activate TAA CD8+ T cells in TME and has potential in alone or in combination with PD-1/PD-L1 mAb, for the treatment of advanced solid tumors, especially for Claudin 18.2 positive PDAC. Methods: This is a FIH, phase 1 study to evaluate the safety, tolerability, pharmacokinetics and immunogenicity of LB4330 in patients with advanced solid tumors (MEETCD8-001). The planned sample size is approximately 66 patients in two parts: part 1 dose escalation, will evaluate safety, tolerability, pharmacokinetics (PK), pharmacodynamics, and determine the maximum tolerated dose (MTD) and/or the recommended phase 2 dose (RP2D). Part 2 dose expansion will further characterize the safety profile and preliminary tumor response in advanced gastric and gastroesophageal junction adenocarcinoma and PDAC with Claudin 18.2 expression. In dose escalation stage, patients will be recruited with advanced solid tumors who have failed standard treatment, or for whom standard treatment is not available or applicable at this stage. Exclusion criteria include a greater risk for gastric bleeding, irritable bowel syndrome with symptoms, active virus infections. The primary endpoints are incidence of dose limiting toxicities and adverse events, MTD, and recommended phase 2 dose. Secondary objectives will evaluate PK parameters, preliminary antitumor activity, and immunogenicity of LB4330. Tumor response will be assessed per RECIST and iRECIST every 2 cycles. The Phase I study in advanced solid tumors is ongoing. Enrollment in cohort 1 began in Nov 2022. Clinical trial information: NCT05707676 .